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Abstrak :
"Understanding Health Insurance, Twelfth Edition, is the essential learning tool you need when preparing for a career in medical insurance billing. This comprehensive and easy-to-understand text is fully updated with the latest code sets and guidelines, and covers important topics in the field like managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. The Twelfth Edition has been updated to include new legislation that affects health care, ICD-10-CM coding, implementing the electronic health record, the Medical Integrity Program (MIP), the medical review process, and more. Practice exercises in each chapter provide plenty of review, and the accompanying workbook provides even more application-based assignments and additional case studies for reinforcement,. Purchase of this text includes access to free online SimClaim CMS-1500 claims completion software and free-trial access to Optum?s EncoderPro.com - Expert encoder software" -- p. [4] of cover.

Abstrak :
ABSTRAK
Skripsi ini membahas mengenai kecurangan pada pelaksanaan Program Jaminan Kesehatan Nasional di Amerika Serikat dan di Indonesia, termasuk siapa saja yang dapat melakukan kecurangan pada pelaksanaan Program Jaminan Kesehatan Nasional di Amerika Serikat Medicare dan Medicaid dan di Indonesia BPJS Kesehatan , khususnya dokter.Selain itu juga membahas bagaimana modus operandinya. Analisis dilakukan dengan cara membandingkan hal-hal yang berkaitan dengan kecurangan pada pelaksanaan Program Jaminan Kesehatan Nasional di kedua negara. Bentuk penelitian ini adalah yuridis normatif dengan metode yang digunakan adalah kualitatif.Hasil penelitian menyimpulkan bahwa kecurangan pada pelaksanaan Program Jaminan Kesehatan Nasional di Indonesia belum banyak ditemukan tidak seperti di Amerika Serikat, namun dokter di kedua negara tetap berpotensi untuk melakukan kecurangan dengan salah satu modus operandinya adalah klaim palsu. .

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ABSTRACT
This undergraduate thesis talks about Healthcare Programs Fraud in United States of America and in Indonesia, also talks about who are the potential parties who can conduct Healthcare Programs Fraud in United States of America Medicare and Medicaid and in Indonesia BPJS Kesehatan , especially physicians. Other than that, this undergraduate thesis also discusses about the modus operandi. Comparison study will be used as the analysis method which will compare everything related to the Healthcare Programs Fraud in both countries. This research form is normative juridical with qualitative method. The research concludes that Healthcare Programs Fraud in Indonesia is not found as much as in United States of America, but physicians in both countries still potentially conduct the Healthcare Programs Fraud with one of the method is false claim.

Abstrak :
"Home care clinicians everywhere depend on "the little red book" for essential, everyday information: detailed standards and documentation guidelines including ICD-9-CM diagnostic codes, current NANDA-I and OASIS information, factors justifying homebound status, interdisciplinary goals and outcomes, reimbursement considerations, and evidence-based resources for practice and education. Completely revised and updated, this handbook now includes the most recently revised Federal Register Final Rule and up-to-date coding guidelines."--BOOK JACKET.